Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
Home › TX › SAN ANGELO › WAL-MART STORES TEXAS, LLC

WAL-MART STORES TEXAS, LLC

NPI: 1104902451 · SAN ANGELO, TX 76903 · Optician · NPI assigned 10/30/2006

$9K
Total Medicaid Paid
254
Total Claims
238
Beneficiaries
4
Codes Billed
2021-01
First Month
2024-11
Last Month

Provider Details

Authorized OfficialLEVINE, LAURA (MGR GOV CONTRACTING)
Parent OrganizationWAL-MART STORES INC
NPI Enumeration Date10/30/2006

Related Entities

Other providers sharing the same authorized official: LEVINE, LAURA

ProviderCityStateTotal Paid
SAMS WEST INC DENVER CO $9K
SAMS WEST INC HONOLULU HI $6K
SAMS WEST INC AURORA CO $1K
SAMS EAST INC WINSTON SALEM NC $715.00
SAMS WEST INC RENO NV $0.00
SAMS EAST INC METAIRIE LA $0.00

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2021 54 $727.69
2022 12 $810.87
2023 72 $2K
2024 116 $5K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
V2025 Deluxe frame 70 70 $6K
V2103 Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens 76 72 $1K
V2020 Frames, purchases 79 68 $1K
V2750 Anti-reflective coating, per lens 29 28 $350.82